Primary Cicatricial Alopecia: Diagnosis and Treatment

May 2013 in “ Canadian Medical Association Journal ”

Rebecca Filbrandt, Nicholas W Rufaut, Leslie Jones, Rodney Sinclair

primary cicatricial alopecia hair follicles scar tissue anti-inflammatory drugs immunosuppressive drugs topical steroids intralesional triamcinolone hydroxychloroquine psychological support antigens cell-bound targets folliculocentric attack steroids triamcinolone Plaquenil

TLDR Primary cicatricial alopecia, a rare disorder causing permanent hair loss, is hard to diagnose and treat, with treatments like anti-inflammatory drugs and steroids offering varied results and no guaranteed cure. Psychological support for patients is important, and future research should aim to identify causes of the condition.

The 2013 document discussed primary cicatricial alopecia, a group of rare disorders causing permanent hair loss by destroying hair follicles and replacing them with scar tissue. The condition was challenging to diagnose and treat, with no known cause, and represented about 7% of patients in specialist hair loss clinics. The document emphasized early diagnosis to prevent further hair loss and suggested treatments including anti-inflammatory or immunosuppressive drugs, topical steroids, intralesional triamcinolone, and hydroxychloroquine. However, treatment effectiveness varied and there was no guaranteed cure. The document also highlighted the psychological impact of hair loss and recommended psychological support for patients. It also suggested future investigations should focus on identifying antigens or cell-bound targets and triggers for the folliculocentric attack.

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Research cited in this study

16 / 16 results

research Sebaceous Gland Loss and Inflammation in Scarring Alopecia: A Potential Role in Pathogenesis

37 citations, June 2011 in “Journal of The American Academy of Dermatology”

Loss of sebaceous glands and inflammation may contribute to the development of scarring alopecia.

research Central Hair Loss in African American Women: Incidence and Potential Risk Factors

76 citations, November 2010 in “Journal of The American Academy of Dermatology”

Some African American women's central scalp hair loss is linked to genetics and past fungal scalp infections, with more research needed on other causes.

research The Pathogenesis of Primary Cicatricial Alopecias

150 citations, October 2010 in “The American Journal of Pathology”

The document concludes that more research is needed to better understand and treat primary cicatricial alopecias, and suggests a possible reclassification based on molecular pathways.

research Genome-Wide Association Study in Alopecia Areata Implicates Both Innate and Adaptive Immunity

717 citations, June 2010 in “Nature”

Alopecia areata involves both innate and adaptive immunity, with specific genes linked to the disease.

research Efficacy and Safety of Mycophenolate Mofetil for Lichen Planopilaris

66 citations, January 2010 in “Journal of The American Academy of Dermatology”

Mycophenolate mofetil was effective for most patients in treating scarring hair loss, but some had side effects.

research Lichen Planopilaris Treated With a Peroxisome Proliferator-Activated Receptor Gamma Agonist

105 citations, December 2009 in “Archives of dermatology”

A specific drug can help treat Lichen Planopilaris, a condition causing permanent hair loss.

research Diffuse Hair Loss: Its Triggers and Management

88 citations, June 2009 in “Cleveland Clinic Journal of Medicine”

To manage diffuse hair loss, identify the cause, improve nutrition, remove triggers, and use specific treatments like minoxidil or finasteride.

research Modern Artificial Hair Implantation: A Pilot Study of 10 Patients

9 citations, November 2008 in “Journal of Cosmetic Dermatology”

Artificial hair implantation is generally safe and can restore hair when other treatments fail, but some patients may experience side effects.

research Frontal Fibrosing Alopecia: Treatment with Oral Dutasteride and Topical Pimecrolimus

69 citations, August 2008 in “Journal of The European Academy of Dermatology and Venereology”

Oral dutasteride and topical pimecrolimus can safely and effectively treat Frontal Fibrosing Alopecia, leading to significant hair regrowth.

research Management of Primary Cicatricial Alopecias: Options for Treatment

98 citations, May 2008 in “British Journal of Dermatology”

There are many treatments for permanent hair loss disorders, but their effectiveness varies and there's no clear best option.

research Therapeutic Strategies for Treating Hair Loss

42 citations, March 2006 in “Drug Discovery Today: Therapeutic Strategies”

The conclusion is that we need more effective hair loss treatments than the current ones, and these could include new drugs, gene and stem cell therapy, hormones, and scalp cooling, but they all need thorough safety testing.

research The Medical Treatment of Cicatricial Alopecia

46 citations, March 2006 in “Seminars in Cutaneous Medicine and Surgery”

Current treatments for cicatricial alopecia can manage symptoms but don't stop hair loss or the disease.

research Hair Transplantation: Current Concepts and Techniques

30 citations, October 2005 in “Journal of Investigative Dermatology Symposium Proceedings”

The document concludes that hair transplantation is recommended for those not helped by medical treatments, but warns that high-density transplants may lower hair survival rates.

research Primary Cicatricial Alopecias: Clinicopathology of 112 Cases

254 citations, December 2003 in “Journal of the American Academy of Dermatology”

Accurate diagnosis and aggressive treatment are crucial to prevent permanent hair loss in cicatricial alopecia.

research The Psychosocial Consequences of Androgenetic Alopecia: A Review of the Research Literature

180 citations, September 1999 in “British Journal of Dermatology”

Hair loss affects self-esteem and quality of life; treatments can help.

research Evaluation of Hair Loss

21 citations, May 1996 in “Current problems in dermatology”

Detailed patient history and physical exams are crucial for diagnosing hair loss.

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